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        <div id="u833_state0" class="panel_state" data-label="State1" style="">
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            <!-- Unnamed (组合) -->
            <div id="u834" class="ax_default" data-left="0" data-top="0" data-width="0" data-height="0" layer-opacity="1">
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            <!-- Unnamed (矩形) -->
            <div id="u835" class="ax_default box_1 transition notrs">
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                <p><span>提交</span></p>
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                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; 此部分将了解您从事康复的信心程度，以下是假设的情况，“0”代表没什么信心”，“10”代表“非常有信心”，请根据您的实际情况选择最适合的答案。</span></p>
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                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 1—2—3—4—5—6—7—8—9—10</span></p><p><span>&nbsp;&nbsp; &nbsp; 完全没信心&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; 非常有信心</span></p>
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            <div id="u840" class="ax_default box_1 transition notrs">
              <div id="u840_div" class=""></div>
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                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 1—2—3—4—5—6—7—8—9—10</span></p><p><span>&nbsp;&nbsp; &nbsp; 完全没信心&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; 非常有信心</span></p>
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                <p></p>
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            <div id="u842" class="ax_default box_1 transition notrs">
              <div id="u842_div" class=""></div>
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                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 1—2—3—4—5—6—7—8—9—10</span></p><p><span>&nbsp;&nbsp; &nbsp; 完全没信心&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; 非常有信心</span></p>
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            </div>

            <!-- Unnamed (矩形) -->
            <div id="u843" class="ax_default box_1 transition notrs">
              <div id="u843_div" class=""></div>
              <div id="u843_text" class="text ">
                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 1—2—3—4—5—6—7—8—9—10</span></p><p><span>&nbsp;&nbsp; &nbsp; 完全没信心&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; 非常有信心</span></p>
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            <!-- Unnamed (矩形) -->
            <div id="u844" class="ax_default box_1 transition notrs">
              <div id="u844_div" class=""></div>
              <div id="u844_text" class="text ">
                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 1—2—3—4—5—6—7—8—9—10</span></p><p><span>&nbsp;&nbsp; &nbsp; 完全没信心&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; 非常有信心</span></p>
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            <!-- Unnamed (矩形) -->
            <div id="u845" class="ax_default box_1 transition notrs">
              <div id="u845_div" class=""></div>
              <div id="u845_text" class="text ">
                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 1—2—3—4—5—6—7—8—9—10</span></p><p><span>&nbsp;&nbsp; &nbsp; 完全没信心&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; 非常有信心</span></p>
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                <p><span>1. 能够每晚让自己轻松地上床</span></p>
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            <div id="u848" class="ax_default box_1 transition notrs">
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                <p><span>2. 即使感到疲惫仍能自己下床</span></p>
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                <p><span>5. 能够自己在室外任何地面（如平地、凹凸不平地面、上</span></p><p><span>&nbsp;&nbsp; 下台阶、坡道、草地等）上安全地走动</span></p>
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              <div id="u850_div" class=""></div>
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                <p><span>4. 能够在你家四处走动去做你想做的大部分事情（如洗漱、</span></p><p><span>&nbsp;&nbsp;&nbsp; 洗澡、晾晒衣物、如厕、打扫卫生、应门或电话等）</span></p>
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            <div id="u851" class="ax_default box_1 transition notrs">
              <div id="u851_div" class=""></div>
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                <p><span>3. 能够在你家的任何地面上（包括湿滑地面）自己走几步</span></p>
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              <div id="u852_div" class=""></div>
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                <p><span>6. 能够自己端碗用勺（筷子）吃饭</span></p>
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                <p><span>7. 即使感到疲惫也能够自己穿衣服和脱衣服</span></p>
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                <p><span>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 1—2—3—4—5—6—7—8—9—10</span></p><p><span>&nbsp;&nbsp; &nbsp; 完全没信心&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; 非常有信心</span></p>
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                <p></p>
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                  <p><span>问卷-自我效能</span></p>
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                <p><span style="font-family:'FontAwesome', sans-serif;font-weight:400;"> </span><span style="font-family:'微软雅黑', sans-serif;font-weight:400;">返回</span></p>
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